neurovascular supply of gluteal region
TRANSCRIPT
NEUROVASCULAR SUPPLY OF GLUTEAL REGION
MOHAMMED MUNEER University of Karbala
• Superior gluteal artery• Inferior gluteal artery• They are branches of the internal
iliac artery• They supply the gluteal region• Obturator artery is abranch of
the internal iliac artery • It passes through obturator
foramen• It supplies the medal side of the
upper thigh
Femoral Artery• It is the contiuation of
the external iliac artery at the mid inguinal point
• It descends in the femoral triangle
• Then, it continues in the adductor canal
• It reaches the adductor hiatus where it becomes the popliteal artery
• It supplies all structures in the thigh
Femoral Artery
In the femoral triangle, it gives the following branches:
3 superficial branchesSuperficial circumflex iliac arterySuperficial Epigastric arteryExternal pudendal artery 3 deep branchesDeep artery of the thighDeep external pudendal Descending genicular
Deep Artery of the Thigh
• It is the main artery of the thigh• It gives the following branches• Medial circumflex femoral artery• Lateral circumflex femoral artery
which gives a descending branch• Perforating arteries
Arteries of Gluteal Region
Superior gluteal-from internal iliac posterior division above piriformis
Inferior gluteal-from internal iliac anterior division-below piriformis
Trochanteric anastomosis- main supply to head of femur. Retinacular nutrient arteries pass along neck of femur to head.
Formation 1. Superior gluteal A2. Inferior gluteal A3. Medial Circumflex A4. Lateral circumflex A
Cruciate anastomosis5. Inferior gluteal6. MCF and LCF7. 1st perforating branch of PFA
Superior gluteal artery• Branch from posterior division of the internal iliac
artery• Leaves the pelvis by passing through the greater
sciatic foramen above the piriformis muscle
INFERIOR GLUTEAL ARTERYArises from anterior division of Internal iliac artery.
• Leaves the pelvis by passing through the greater sciatic foramen below the piriformis muscle
Trochanteric Anastomosis Is the main supply to the head &
neck of femur Provides a connection between
internal iliac and femoral arteries Lies near the trochanteric fossa,
branches run along the femoral neck beneath the reticular fibers of the capsule
Formed by: Descending branches of
superior and inferior gluteal arteries &
Ascending branches of lateral and medial circumflex arteries
Posterior view
Arterial supply to Femoral head
• Medial & lateral femoral circumflex arteries
• Superior and inferior gluteal arteries
• Post. obdurator artery via artery of femoral ligament
TROCHANTERIC ANASTOMOSIS
Cruciate Anastomosis Lies at the level of lesser
trochanter Provides a connection between
internal iliac and femoral arteries
Formed by: Descending branch of
inferior gluteal artery Transverse branches of
medial and lateral circumflex arteries &
Ascending branch of first perforating artery
•The sacral plexus supplies innervation to the pelvic muscles, gluteal muscles, and perineal muscles. It also forms the sciatic nerve.
Sacral plexus Formed by the 4th & 5th lumbar ventral rami (lumbosacral trunk) and S1234
• Forms on the ventral surface of the piriformis muscle
Sciatic nerve (L4, L5, SI, S2, S3) • Is the largest branch of the sacral plexus and the largest nerve in body
• Consists of two separate nerves, the common peroneal nerve and the tibial nerve• Leaves the pelvis through the greater sciatic foramen below the piriformis muscle
Superior gluteal nerve (L4, L5, S1) • Leaves the pelvis through the greater sciatic foramen abovethe piriformis muscle with the superior gluteal artery and vein
• In the gluteal region supplies the gluteus medius, the gluteus minimus, the tensor fasciae latae, and the hip joint
Inferior gluteal nerve (L5, S1, S2)• Leaves the pelvis through the greater sciatic foramen below the piriformis muscle with the inferior gluteal artery and vein
• In the gluteal region supplies the gluteus maximus muscle
Posterior femorai cutaneous nerve (SI, S2, S3)
• Leaves the pelvis through the greater sciatic foramen inferior to the piriformis
• In the gluteal region descends on the posterior surface of the sciatic nerve
• Supplies the skin of the buttocks, posterior thigh, popliteal fossa, and external genitalia
Nerve to the obturator internus (L5, S1, S2)
• Leaves the pelvis through the greater sciatic foramen below the piriformis muscle • In the gluteal region descends on the superior gemellus muscle to pass below the ischial spine and enter the lesser sciatic foramen
• Supplies the superior gemellus and obturator internus muscles
Nerve to the quadratus femoris (L4, L5, SI) • Leaves the pelvis through the greater sciatic foramen below the piriformis muscle and deep to the sciatic nerve
• In the gluteal region runs anterior to the superior and inferior gemellus and obturator internus muscles
• Supplies the inferior gemellus and quadratus femoris muscles
Pudendal nerve (S2, S3, S4) • Leaves the pelvis through the greater sciatic foramen inferior to the piriformis muscle along with the internal pudendal artery and vein
• In the gluteal region descends posterior to the ischial spine and enters the lesser sciatic foramen
• Is distributed to the perineum and has no branches in the gluteal region
